Pulmonologist

Yesterday Adam had his first appointment with the pulmonologist. I called a couple of weeks ago because it seemed like Adam was in pain every night, and while his spitting up had gotten better since starting the Nexium, it really only improved with age, as it does with every baby. Plus, the cough and congestion that he has had since he was two months old was still around whether he had a cold or not. He has been on Nexium for almost 3 months and I haven't seen any improvement directly related to that - the only improvement I have seen are related to the little tricks that Shannon and I have picked up over the last couple of months. I just couldn't wait another month and a half to "follow up" with the stupid Gastrolentologist, who is so convinced I'm over-reacting and who has no interest in hearing me out.

So I made an appointment for Monday morning.

Of course, just when you say "enough is enough," and make an appointment with a doctor, isn't it typical that the symptom you were the most worried about improves or disappears altogether? Adam hasn't been acting like he's in pain lately, but the spitting up is still around - his shirt is constantly soaked, there are spit up cloths everywhere, all over the house, and we change his clothes at least twice a day - usually three times. And yes, "babies do spit up." I get that.

Adam started a 10 day cycle of amoxicillan on the 3rd, but it wasn't working after 5 days so we were given a new antibiotic. He finished the new 10 day cycle of antibiotics on Sunday the 19th. By Friday the 24th, he had a new cold. 15-16 days on antibiotics, 4 days healthy, and already a new cold. He hadn't even been at daycare much that week.

Because I had been so completely written off at the gastroentologist, I was nervous. But a friend had given me Dr. Peter Schochet's name and I was done trying to pretend that the constant colds, the constant chest congestion, the constant spitting up, and the nighttime pain  was "normal".

Of course, since it was 2 days after Christmas, we had a pretty long wait at Dr. Schochet's office. For an appointment time of 10:30am, I had a pretty bored, tired, and hungry baby when we finally saw the doctor at 12:15 pm.

Ready to go home!

But I liked Dr. Schochet. Even though we waited a while to see him, he at least sat down with us and thought about the problem and let me talk about what was going on.

He looked over Adam's symptoms and asked if Adam's soaked shirt was a normal thing, which of course, it is (and what he was looking at wasn't as bad as it could get). He said that since Adam wasn't dying and was obviously thriving, he usually addressed things practically and didn't want to start out by ordering a million tests. He said that obviously there was something going on and a constantly soaked shirt and gallons of drool wasn't normal. He said he actually didn't believe the problem was related to acid reflux, but perhaps to a problem with his swallowing, which could lead to the constant colds (a sort of reverse reflux that causes some of his food to go up into his nasal cavity), the chest rattling and congestion (part of the formula goes into his lungs), and of course, the spitting up and drool. The pain he is having at night could be from him swallowing so much mucus since he's been sick so much over the past 4 months.

He gave us a 3 week antibiotic for Adam's constant cold, which he believes is just one cold that isn't going away completely. With this antibiotic he recommends yogurt every day, even twice a day. Poor Adam, having to eat his favorite food every day for three weeks. How miserable. :)
 
Anyway, long story wrapping up - Adam is having a swallow study next Tuesday. He will have to drink/eat barium while they x-ray his chest to see how he swallows... and I'm not worried, really. I guess I haven't had time to think about whether this is the problem - the idea in and of itself is new to me - and Dr. Schochet said it wasn't a huge deal if this was the problem. We would just know for sure that Adam would need his formula/juice thickened with something other than rice cereal.

And I guess just knowing what is actually the problem (and not having to buy/prepare/give Nexium twice every day when it wasn't really working) is enough for me, right now.

Oh, and this is something that clearly the gastroentologist could have ordered herself if she had taken the time. I have already explained to our pediatrician that I wasn't impressed or going back to the gastrolentologist she recommended (and she said thank you for telling her - they didn't like referring to doctors that didn't seem helpful). If this does turn out to be the problem, Dr. Mona Dave will be getting a note from me.